Arctigeninのヒト肝芽腫細胞株に対する抗腫瘍効果の検討

藤田医科大

Minimal laparotomy management of a giant ovarian cystic teratoma in adolescence

Giant ovarian cysts in adolescents are very rare. Those treatment by laparotomy or laparoscopic surgery is discussed with gynecologists and pediatric surgeons because its limited working space and risk of rupture and malignancy. We present a case of minimal laparotomy management of a giant ovarian cystic teratoma in adolescent. A 13-year-old girl presented with abdominal pain and constipation. A CT scan showed a giant simple ovarian cystic tumor in her abdomen measuring 29 × 13 × 24 cm. We made a 3-cm Pfannenstiel incision and inserted an Alexis wound retractor XS. The cyst was completely aspirated without spillage in the intraperitoneal space. In total, 6L of murky brown fluid was aspirated from the cyst. There was no ovarian tissue visible on the cyst wall. The left tube and right ovary and tube were intact. The cyst wall and left ovary tube were dissected free by using a LigaSure. Postoperative recovery was uneventful. Pathological assessment revealed a mature cystic teratoma. The ovarian tissue was included in the part of the cyst wall. We were able to safely perform with minimal laparotomy. Therefore, we consider the for cases of giant ovarian tumors, minimal laparotomy surgery is useful from the safety and cosmetic perspective

Segmental dilatation of colon detected on prenatal ultrasound

Segmental dilatation of the colon is a rare condition in which there is an abrupt segment of dilated colon between regions of normal colon, without obstruction. The condition causes bilious vomiting and abdominal distention in the neonate, and causes constipation or anemia in infants and adults. We herein report a case of segmental dilatation of the descending colon detected on prenatal sonography. The patient was born at 39 weeks' gestation, weighing 3720 g. At 10 months, he developed constipation and enterocolitis. At 1 year of age, the patient underwent laparoscopic-assisted resection of dilated colon with end-to-end anastomosis. Resection of the dilated segment alone was not sufficient, according to frozen biopsy. Therefore, we resected an additional 3 cm both proximally and distally, where teniae coli were grossly evident. Histological examination of the dilated segment showed muscular layer hypertrophy with hyperplasia and widening of Auerbach's plexus. The patient's 7-month follow-up was unremarkable. With improved quality of prenatal sonography, more patients will be diagnosed with segmental dilatation of the intestine. This is the first report in the English literature of segmental dilatation of the colon detected on prenatal ultrasound. Keywords: Segmental dilatation of colon, Segmental dilatation of intestine, Prenatal ultrasoun

A new murine ileostomy model: recycling stool prevents intestinal atrophy in the distal side of ileostomy

OBJECTIVES: Proximal stoma creation in neonates results in growth failure and distal intestinal atrophy. “Recycling stool” consists of stool injection from the proximal limb to the distal limb of a stoma. Because this method may prevent distal bowel atrophy and increase body weight, we investigated the effects of recycling stool upon distal intestinal mucosa by generating an ileostomy model in rats. METHODS: An ileostomy was created 5 cm proximal to the cecum in male Wistar/ST rats. Discharged stool or saline was injected into the distal limb, twice per day for 7 days. The intestinal adaptation was assessed by measuring the villus height and counting goblet cell number. Proliferation and apoptosis were analyzed by Ki67 and TUNEL immunostaining. RESULTS: The ratios of the height of the distal villi (D) to the that of proximal villi (P) were 0.97 (median [range] of D and P length: 421 [240–729] μm and 436 [294–638] μm, P<0.05) in the stool-injected group and 0.81 in the saline-injected group (442 [315–641] μm and 548 [236–776] μm, P<0.05). Compared with the saline-injected group, the stool-injected group showed elevated numbers of goblet cells (3.6 [2.0–7.6] vs. 4.9 [2.4–7.5] cells/100-μm villus length) and Ki67-positive cells (26.8% [13.8%–35.4%] vs. 40.1% [31.2%–45.7%]), along with a reduced number of apoptotic cells (5.0 [2.0–14.0] vs. 4.0 [1.0–9.0] cells/100-μm villus length). CONCLUSIONS: Recycling stool prevented distal intestinal atrophy; this experimental design may facilitate further studies concerning alternative methods to prevent intestinal atrophy and growth failure